Androgens and the ageing male

Area of Science:

• Endocrinology
• Men's Health
• Geriatrics

Background:

• Hypogonadism presents with symptoms like decreased muscle mass, fatigue, and low libido.
• Androgen substitution therapy is proven effective for severe hypogonadism.
• The term 'andropause' is sometimes used for age-related symptoms in men.

Purpose of the Study:

• To evaluate the appropriateness of androgen substitution therapy in men.
• To address the concept of 'andropause' and its scientific validity.
• To assess the risks and benefits of testosterone therapy in elderly men.

Main Methods:

• Review of controlled trials on androgen substitution therapy in hypogonadal men.
• Analysis of prospective studies on age-related testosterone level variations.
• Assessment of the lack of placebo-controlled studies in elderly males regarding testosterone therapy risks.

Main Results:

• Androgen therapy is beneficial for men with confirmed hypogonadism.
• Testosterone levels show minimal decline with age; 'andropause' is not scientifically supported.
• There is a lack of data on adverse effects, like prostate cancer, from testosterone treatment in elderly men.

Conclusions:

• Androgen therapy is warranted for diagnosed hypogonadism across all ages.
• The term 'andropause' is misleading; men do not experience a menopausal decline in testosterone.
• Widespread testosterone use in elderly men is inappropriate due to insufficient risk assessment and lack of evidence.